Microsoft word - adl report for portfolio2

ACTIVITIES OF DAILY LIVING ASSESSMENT REPORT Claimant Name: Date of Birth: Claim No: Employer:
Child Support Agency (Department of Human Services)
Type of Injury: Date of Injury: Date Referred for Assessment: Date of Assessment: Documentation Reviewed:
Comcare referral documentation, previous medical reports
Konekt Consultant: Consultant Contact Number: ASSESSMENT OBJECTIVES
Comcare requested that Konekt conduct an ADL Assessment of Ms Russell’s living
arrangement in order to assess the amount of household services Ms Russell requires
as a result of her accepted compensable condition.
To provide answers to the schedule of questions as per the Comcare referral.
Konekt Australia Pty Ltd ABN 64 083 660 093 2/12 Technology Drive Warana QLD 4575 Tel 07 5437 1702 Fax 07 5438 8285 www.konekt.com.au BACKGROUND INFORMATION
Ms Russell reported that she worked for the Child Support Agency, initially as a financial
investigator, where she experienced difficulties with a reportedly unjust system (having to
sign off on documents she didn’t agree with) and dealing with customers in vulnerable
positions. Ms Russell reported that when she communicated her difficulties to her
supervisor she was told to “suck it up”. During this time (2007), Ms Russell reported feeling
quite depressed and identified her symptoms as weight loss, reduction of sleep and
vomiting (most mornings). As a result, she reportedly made a threat of sick leave and was
consequently moved to lighter duties before going into the objections team (2007) with
In 2008, Ms Russell reported her best friend died (in August) and her father also past-away
in the same year (October). In September 2008, Ms Russell reported ceasing work and
attempting to commit suicide multiple times. Ms Russell stated that she was admitted to
both Prince Charles Hospital (psychiatric admission) and Royal Brisbane hospital and also
the New Farm Clinic over the past 5 years with the most recent admission being on the 19th
Ms Russell reportedly underwent Transcranial Magnetic Stimulation (TMS) during her last
hospital admission at Pine Rivers. Ms Russell reported minimal effect from the treatment
although it was still “early days”. In addition, Ms Russell reported taking a variety of
medications for her major depressive disorder. As per Dr Ng’s medical report dated 29th
January 2013, Ms Russell is currently taking the following medications per day:
Ms Russell reported that at her previous residence (Banyo) she was receiving fortnightly
outreach assistance. The aim of this service was to improve Ms Russell’s motivation. Ms
Russell reported that the outreach worker was endeavouring to source household
assistance for Ms Russell however these attempts were unsuccessful because there was
no funding through the government organisations as Ms Russell was not elderly or suffering
from a physical condition. At the time, Ms Russell was not aware that she could request
Injury / Medical History
Ms Russell has been diagnosed with major depressive disorder as outlined in Dr Bradley
Ng’s (Psychiatrist) medical report dated 29th January 2013. Ms Russell also reported a
diagnosis of Rheumatoid Arthritis (non-compensable condition).
Psycho Social Situation
Konekt observed Ms Russell to reside alone at 33 Gipps Street, Nanango. Ms Russell’s
mother Elaine Russell was present at the time of the assessment and resides a few streets
away at 23 Chester Street, Nanango. Ms Russell reported not socialising with anyone other
than close family members such as her mother and brother.
Description of Dwelling
Konekt observed Ms Russell’s residence to be a four bedroom spacious home containing
two bathrooms, two living rooms and a lock up garage. The home is a corner block, single
level home with a moderate size front and backyard.
SELF CARE
Ms Russell reported to Konekt that she experiences low mood, low energy and very poor
motivation as a result of her depressive disorder. Ms Russell described her symptoms as a
“constant daily occurrence”. As a result, Ms Russell reported being unable, most days, to
shower or dress independently. This was evident to Konekt whereby Konekt observed Ms
Russell to be dressed in pyjamas (at 11am) with a distinct odour possibly due to a lack of
adequate bathing. Although Ms Russell reported she is physically able to shower she is
currently lacking the motivation to do so. This was confirmed by her mother (present at the
time of the assessment) who stated that she has to prompt her daughter to shower and eat
on a daily basis. Nevertheless, Ms Russell reported to Konekt only showering
approximately every 4 days. Konekt observed Ms Russell’s bathroom to be sound with
Grooming
Ms Russell reported not having the motivation, energy or will to dress herself. Konekt
observed Ms Russell to be wearing old, worn pyjamas with little effort demonstrated to be
well presented for the assessment. When discussed, Ms Russell stated that she “cannot be
bothered to get dressed”. Currently Ms Russell does not leave the house for any reason
except every three weeks when she returns to Brisbane for her doctor’s appointments and
treatments. Elaine Russell (Ms Russell’s mother) stated that even then sometimes Ms
Russell does not dress appropriately whilst attending the doctor appointments. In addition,
Elaine also reported that when Ms Russell did shower (approximately every 4 days) she
doesn’t always put clean clothes on after a shower. Ms Russell reported no physical reason
why she is unable to dress herself apart from occasionally finding buttons difficult to do up
because of her Rheumatoid Arthritis (non-compensable condition). Ms Russell reported the
main reason for not dressing is due to low motivation.
Eating
Ms Russell reported to Konekt not eating regular meals. When discussed, Ms Russell could
not recall the last time she cooked a meal. She stated that her mother comes daily with
prepared meals or to prompt her to eat a sandwich. Ms Russell reported that she regularly
makes a coffee every morning however doesn’t feel motivated to eat and specifically isn’t
motivated to prepare meals. Konekt observed a spacious kitchen, well equipped, however
with dirty dishes on the sink. It is important to note that Ms Russell has a history of Bulimic
behaviour as outlined in Dr Bradley Ng’s medical report dated 29th of January 2013.
Sleeping
Ms Russell reported to Konekt that she sleeps excessively. Her mother, Elaine, confirmed
this statement and reported that she comes over around 10am on a daily basis to
encourage her daughter to get out of bed. Ms Russell reported always feeling tired and
upon waking would normally make a cup of coffee and lay on the couch to watch television.
Ms Russell also reported she has no energy to make her bed. This was evident to Konekt
as her bed was unmade at the time of the assessment and the smaller living room
appeared utilised for regular television watching. Ms Russell reported that she doesn’t
wash her bed sheets. Ms Russell reported that she has only recently bought a washing
machine and hasn’t yet plugged it in therefore her mother is currently washing her sheets.
The beds in the spare two rooms were made and the rooms appeared very tidy and
unused. The remaining third spare room was used to store boxes but also was being made
DOMESTIC AND HOME MANAGEMENT Cleaning
Ms Russell reported the most difficultly with cleaning. She stated to Konekt that she often
looks at the dirty dishes however is unable to get up to attend to them. Ms Russell stated
that she does not have the energy or motivation to attend to cleaning tasks. Ms Russell
reported to Konekt being so tired and unable to clean the dishes that on a few occasions
she has simply thrown the dirty dishes away. Konekt observed Ms Russell’s house to be
full of boxes that are not yet unpacked (Ms Russell moved to her residence in December
2012). Ms Russell stated that her goal was to unpack one box every day however she has
been unable to do so due to poor motivation and a lack of energy. Ms Russell reported that
her mother, Elaine, has been assisting with the unpacking of the boxes and cleaning the
home. Konekt observed the kitchen to be messy with dirty dishes on the sink and many of
Ms Russell’s belongings still in boxes around the home. Ms Russell also reported that she
had organised self-funded home assistance (cleaning services) in her previous residence at
Banyo due to being unable to attend to the cleaning tasks.
Laundry / ironing
Currently Ms Russell is reportedly unable to complete laundry tasks. She has recently
bought a washing machine however is waiting for her mother’s assistance to plug it in and
help her use it. Currently Ms Russell’s mother is completing her washing for her. Ms
Russell reported not ever doing the ironing and stated that she doesn’t even own an iron.
Shopping
Ms Russell was unable to recall the last time she participated in shopping activities. She
reported that her mother does the shopping for her and brings the food to her home. Ms
Russell reported giving her mother money for the shopping but did not want to go outside
where “people could see her”. Ms Russell reported that she uses the internet regularly and
enjoys tipping the football however has not used the internet to grocery shop.
In addition, Ms Russell reported not currently driving. Ms Russell stated that she was
unable to drive in the mornings due to her medication however was not motivated to drive
anywhere as she didn’t want to leave the house. The last time Ms Russell recalled driving
was to her mother’s home (a few streets away) a couple of months ago. Ms Russell stated
that she doesn’t drive the car to attend to shopping activities and when she is required to
attend doctor’s appointments in Brisbane her mother drives her.
Garden maintenance
Ms Russell reported difficulties with garden maintenance tasks due to a lack of energy and
reported feelings of dizziness and light headedness. She also stated that she experiences
pain in her hands and feet due to Rheumatoid Arthritis when attempting to participate in
gardening activities. Ms Russell also reported being unable to leave the home as a result of
her anxiety. When discussed, Ms Russell stated that she was afraid that people would see
her. This was evident to Konekt when Ms Russell escorted Konekt to view her back yard.
Ms Russell demonstrated anxious symptoms such as closed body language (hugging her
body), appearing fearful and not leaving the back porch area (undercover patio). In
addition, Ms Russell chose not to escort Konekt to view the front yard, possibly due to no
covered areas and access to the street. Ms Russell also reported using self-funding garden
services in her previous residence due to being unable to attend to the gardening tasks
At her current residence, Ms Russell does attend to a small vegetable garden. She likes to
water the vegetable garden and is currently growing herbs and vegetables. When
discussed she reported to Konekt that she doesn’t use them because she doesn’t cook but
she does enjoy watering them a few times a week. Ms Russell reported that her mother is
Minor home maintenance
Ms Russell reported that she has recently purchased her current residence, 33 Gipps
Street, Nanango by means of a bank loan. She stated that her previous residence at Banyo
was being put on the market and she hoped to pay of her current residence when the
Banyo property sells. Ms Russell stated that so far the home hasn’t required any
maintenance however her mother has been prompting Ms Russell to unpack the boxes from
her previous residence and is assisting her with any minor maintenance of the new home.
Ms Russell stated that her only form of leisure is art and craft. She reported that she can
“get lost” in the painting and forget about her troubles. Konekt observed the fourth spare
room in Ms Russell’s residence to be set up for art/craft hobbies. Konekt encouraged the
participation of the art hobbies. At her previous residence (Banyo) Ms Russell stated that
she was walking to the post office every day to check her mail. Currently Ms Russell is not
participating in any exercise activities mainly due to her lack of energy but also not wanting
to leave the house. Konekt discussed the importance of exercise with regards to the
release of “feel good” hormones (endorphins) as well as increasing energy levels. Konekt
also discussed grading the activity of exercise by starting to walk to the letterbox every day
for a week and then going a little further each week. Konekt discussed walking to her
mother’s house (a few streets away) as a longer term goal.
ADDITIONAL COMMENTS 1. Does Ms Russell require household and gardening assistance for her compensable condition of major depressive disorder, single episode? Please provide an explanation and specify the number of hours required.
Konekt recommend that Ms Russell receive 2 hours of fortnightly cleaning
assistance and 2 hours of fortnightly gardening assistance during summer months
and 2 hours of monthly gardening assistance during winter months due to her
compensable condition of major depressive disorder. Konekt observed Ms Russell
to demonstrate significant low mood, reduced energy and fatigue at the time of the
assessment which would affect her ability to perform household and gardening
tasks. For example, Ms Russell displayed slow, quiet, laboured speech and poor
2. What duties are required to be performed by a household assistance provider due to Ms Russell’s compensable condition of major depressive disorder, single episode? How many hours will be required to perform these tasks?
As mentioned previously, Konekt recommend that Ms Russell receive 2 hours of
fortnightly cleaning assistance and 2 hours of fortnightly gardening assistance during
summer months and 2 hours of monthly gardening assistance during winter months
due to her compensable condition of major depressive disorder. The specific duties
to be performed should include; general household cleaning (washing windows,
cleaning kitchen and bathrooms and vacuuming floors) and general garden
assistance (mowing lawns, trimming edges and general landscaping).
3. What restrictions are preventing Ms Russell from attending her household and gardening duties.
At the time of the assessment, Konekt observed Ms Russell to be experiencing
severe depression and anxiety symptoms. These symptoms (low mood, low energy,
poor self-efficacy, fatigue, fear and nervousness) are currently limiting Ms Russell’s
ability to perform household and gardening duties.
4. What duties do you consider Ms Russell would be capable of performing?
At the time of the assessment, Ms Russell appeared to be incapable of performing
household and gardening duties due to the symptoms mentioned previously. For
example, Ms Russell reported only being able to perform basic activities of living
(getting out of bed, showering and eating) due to her mother’s daily prompting and
5. How many people reside at residence, 33 Gipps Street, Nanango, QLD?
Ms Russell reported that she was the only resident at 33 Gipps Street, Nanango.
6. Is there anyone who can be reasonably expected to help Ms Russell with any household or gardening duties? If so please provide a list of duties that are reasonable to expect them to undertake?
Ms Russell reported that she was the only resident at 33 Gipps Street, Nanango.
Her mother, Elaine, resides close by and is a significant support person for Ms
Russell. Because Elaine Russell (mother) does not reside with Ms Russell and
Elaine is providing essential daily help to her daughter in the form that resembles a
carer (preparing meals and prompting her daughter to get out of bed and shower) it
would be unreasonable to expect her to also attend to household and gardening
tasks as she also has her own residence to attend to.
7. Which rooms does Ms Russell reside in on a daily basis?
Ms Russell reported that she resides in her bedroom every night and into late
mornings (approximately 10am); subsequently she resides in the second, smaller,
living room (an old single garage that has been converted into a second living area)
to watch television. Konekt observed these two rooms to be well used in
comparison to the other areas of the home.
8. Will there be a time when Ms Russell could be reasonable expected to self-manage her home duties?
Konekt observed Ms Russell to be experiencing significant difficulties with
household and gardening tasks due to her compensable major depressive disorder.
Konekt is uncertain if there will be a time when Ms Russell could reasonably
manage her home duties however recommend the provision of extensive treatment
before an ADL review be performed in a further 12 months.
9. Are there any aids or appliances you would recommend to assist MS Russell in achieving some independence regarding her activities of daily living?
Due to Ms Russell’s compensable condition being of a psychological nature there
are no aids or appliances that Konekt recommend at this stage. Konekt gave
strategies to enhance mood such as walking which in turn can enhance energy and
motivation levels however without continual follow up and prompting, this may not
occur. Konekt did recommend to discuss this with the local psychiatric nurse who Ms
10. In your opinion, was it reasonable for Miss Russell to receive 2 hours of cleaning on the 17th of January 2013 at her former residence in Banyo as a result of her accepted compensable condition?
Konekt are unable to determine whether it was reasonable for Ms Russell to receive
cleaning services at her previous residence due to not seeing the residence or Ms
Russell’s presentation at that time, however if Ms Russell was experiencing similar
symptoms as was exhibited on the date of the current ADL assessment (2nd April,
2013) Konekt believe that it would have been reasonable for Ms Russell to receive
11. In your opinion, was it reasonable for Miss Russell to receive 3 hours of cleaning on 6th of February 2013 at her former residence in Banyo as a result of her accepted compensable condition?
Konekt are unable to determine whether it was reasonable for Ms Russell to receive
gardening services at her previous residence due to not seeing the residence or Ms
Russell presentation at the time, however if Ms Russell was experiencing similar
symptoms as she was at the time of the ADL assessment (2nd April, 2013) Konekt
believe that it would have been reasonable for Ms Russell to receive cleaning
12. Any other findings or comments you feel may assist Comcare?
Ms Russell reported daily pain when mobilising in and around the home due to her
diagnosis of Rheumatoid Arthritis. Ms Russell stated that her rheumatoid arthritis
does inhibit her ability to perform household duties due to pain and reduced range of
motion in her hands and feet. At the time of the assessment, Ms Russell reported a
pain scale of 5-6 out of 10 in her ankles when performing household duties. Konekt
are aware that the rheumatoid arthritis is a non-compensable condition and have not
taken this condition into account when making their recommendations.
SUMMARY OF CONTACT WITH TREATING PROFESSIONALS
Konekt received a fax from Dr Galvin on the 5th of April 2013 stating that Dr Galvin agreed
that Ms Russell required household assistance in the form of 2 hours of cleaning services
per fortnight and 2 hours of gardening services per fortnight (during summer) and 2 hours of
RECOMMENDATIONS
The following recommendations are based on upon reports and observations made at the
time of the assessment. It should be noted that physically, Ms Russell is capable of
completing these tasks however psychologically, due to her Major Depressive Disorder, she
has extremely low mood, motivation and energy, which has decreased her ability to
complete the following activities at the time of the assessment.
Commencement of gardening services for 2 hours per fortnight during summer
months and 2 hours per month during winter (please see appendix). Please note
due to the location of Ms Russell’s residence, Konekt was unable to obtain multiple
Commencement of household services for 2 hour per fortnight (please see
appendix). Please note due to the location of Ms Russell’s residence, Konekt was
unable to obtain multiple quotes for cleaning services.
Should you require any further assistance with Ms Russell’s case please do not hesitate to
Signature:Konekt Consultant Name: Sarah Carew Appendix have been removed

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